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青岛大学附属医院药学部,山东 青岛 266003
副主任药师,硕士生导师,博士。研究方向:临床药学。电话:0532-82912611。E-mail:sunjialin@qdu.edu.cn
主任药师,硕士生导师,硕士。研究方向:药事管理。电话:0532-82911566。E-mail:lijing7112@qdu.edu.cn
纸质出版日期:2023-05-30,
收稿日期:2022-11-22,
修回日期:2023-04-27,
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孙加琳,李祥鹏,倪倍倍等.降低住院患者静脉输液使用率的“六步法”管理模式探索 Δ[J].中国药房,2023,34(10):1257-1261.
SUN Jialin,LI Xiangpeng,NI Beibei,et al.Exploration of “six-step” management mode to reduce the utilization rate of intravenous infusion in inpatients[J].ZHONGGUO YAOFANG,2023,34(10):1257-1261.
孙加琳,李祥鹏,倪倍倍等.降低住院患者静脉输液使用率的“六步法”管理模式探索 Δ[J].中国药房,2023,34(10):1257-1261. DOI: 10.6039/j.issn.1001-0408.2023.10.20.
SUN Jialin,LI Xiangpeng,NI Beibei,et al.Exploration of “six-step” management mode to reduce the utilization rate of intravenous infusion in inpatients[J].ZHONGGUO YAOFANG,2023,34(10):1257-1261. DOI: 10.6039/j.issn.1001-0408.2023.10.20.
目的
2
探索并建立一种医院静脉输液合理管控的长效机制。
方法
2
在建章立制的基础上,通过“六步法”核心技术策略的探索和实施,建立了静脉输液管控新模式,即第一步,无需静脉输液病种制定;第二步,可替代药品/剂型梳理;第三步,可替代用药途径梳理;第四步,用药规范制定;第五步,科室个性化用药需求探索;第六步,科室输液整合方案制定。以住院患者静脉输液使用率和住院患者平均每床日静脉输液使用量为主要指标评价管控效果。
结果
2
“六步法”管理模式在我院胸外科试点实施后,管控前后3个月的平均住院患者静脉输液使用率降低了1.74%,住院患者平均每床日静脉输液使用量降低了0.30袋/瓶,重点管控输液药品的人均用量逐渐下降。
结论
2
“六步法”管理模式可降低住院患者静脉输液使用率,该管理模式切实可行。
OBJECTIVE
2
To explore and establish a long-term mechanism for rational control of intravenous fluids in hospitals.
METHODS
2
On the basis of the establishment of rules and regulations, through the exploration and implementation of the core technical strategy of “six-step method”, a new mode of intravenous infusion control was established. The contents of the “six-step method” were as follows: the first step was to sort out the diseases that did not require intravenous infusion; the second step was to sort out the alternative drugs/dosage forms; the third step was to sort out the alternative routes of infusion; the fourth step was to develop drug specifications; the fifth step was to explore the personalized medication needs of clinical departments; the sixth step was to develop a department-specific integrated infusion regimen. The utilization rate of intravenous fluids in inpatients and the average daily amount of intravenous fluids per bed in inpatients were used as the main indicators to evaluate the control effect.
RESULTS
2
The comparison of the average values of three months before and after the implementation of the “six-step” management mode in the department of thoracic surgery of our hospital showed that after management and control, the average utilization rate of intravenous fluids in inpatients decreased by 1.74%, the average daily use of intravenous fluids in inpatients per bed decreased by 0.30 bags/bottle, and the per capita use of infusion drugs under key control gradually decreased.
CONCLUSIONS
2
The “six-step” management mode can reduce the utilization rate of intravenous fluids in inpatients, and this management mode is practical and feasible.
静脉输液使用率输液管理用药规范
infusion managementmedication specifications
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国家卫生健康委员会.国家卫生健康委办公厅关于印发2022年国家医疗质量安全改进目标的通知[EB/OL].(2022-03-02)[2022-08-02]. http://www.nhc.gov.cn/yzygj/s3585/202203/ffed3474b1884058841a07c144ad094e.shtmlhttp://www.nhc.gov.cn/yzygj/s3585/202203/ffed3474b1884058841a07c144ad094e.shtml.
National Institute for Health and Care Excellence. Intravenous fluid therapy in adults in hospital[EB/OL].(2017-05-05)[2022-08-02]. https://www.nice.org.uk/guidance/cg174/ chapter/1-Recommendations#principles-and-protocols-for-intravenous-fluid-therapy-2https://www.nice.org.uk/guidance/cg174/chapter/1-Recommendations#principles-and-protocols-for-intravenous-fluid-therapy-2.
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